This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. (The First Steps Neurobehavioral and Cognitive Intervention) FANCI will result in more improvement on short term functional measures compared to standard interdisciplinary rehabilitation treatment for patients with moderate to severe TBI. (2) FANCI will result in more improvement on measures of neurobehavioral functioning and effort/participation in rehabilitation therapies compared to standard interdisciplinary rehabilitation treatment for patients with moderate to severe TBI. The Specific Aims include: The specific aims of the proposed study are to (1) evaluate the efficacy of FANCI for improving functional status following treatment using the FIM through a randomized, controlled trial of the methodology, (2) examine the impact of FANCI on broader outcome measures of general emotional and behavioral functioning and productive activity in the community as measured post-treatment and at 6-month follow-up, (3) examine contributions of participant injury severity and cognitive status at time of treatment to treatment outcome and treatment response, (4) examine contributions of the treatment variables of lesson topic and mastery, caregiver presence, and concurrent therapies on treatment outcome and treatment response for inpatients with TBI.